Organization
CHRISTINE DIEVENDORF WEISS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE DIEVENDORF WEISS MA (OWNER)
(269) 520-0050
Entity
Organization
Contact information
Practice address
5400 HOLIDAY TER STE 200A, KALAMAZOO, MI 49009-2161
(269) 520-0050
(269) 520-0051
Mailing address
5400 HOLIDAY TER STE 200A, KALAMAZOO, MI 49009-2161
(269) 520-0050
(269) 520-0051
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401011020
MI
103TC1900X
Counseling Psychologist
6301013930
MI
Other
Enumeration date
11/10/2017
Last updated
05/03/2020
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